<!DOCTYPE html>
<html lang="zh-CN">

<head>
    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0,user-scalable=no">
    <meta http-equiv="Cache-Control" content="no-cache" />
    <meta name="description" content="长沙市妇幼医院">
    <link rel="stylesheet" type="text/css" href="./css/area/LArea.css" />
    <link rel="stylesheet" type="text/css" href="./css/order/order_normal.css" />
    <link rel="stylesheet" type="text/css" href="./css/mobiscroll.2.13.2.css" />
    <script src="./js/jquery.min.js"></script>
    <script src="./js/mobiscroll.2.13.2.js"></script>
    <script src="./js/area/LAreaData2.js"></script>
    <script src="./js/area/LArea.js"></script>
    <script src="./js/idcard.js"></script>
    <script src="./js/set-customer.js"></script>

    <!-- 省市区 -->
    <script type="text/javascript" src="/csfy/static/manage-sys/js/cj-pcd/cj-pcd-1.0.1.min.js"></script>
    <!-- 自动补全-->
    <script type="text/javascript" src="./js/order/autoComplete.js"></script>
    <title>长沙市健康民生项目</title>
    <style>
        .remark {
            font-size: 12px;
            color: #07b8dd;
        }

        .sub-sheet {
            font-size: 12px;
        }
    </style>

    <style>
        body {
            font-family: "Microsoft YaHei UI", "Microsoft YaHei", "ff-tisa-web-pro-1", "ff-tisa-web-pro-2", "Lucida Grande", "Helvetica Neue", Helvetica, Arial, "Hiragino Sans GB", "Hiragino Sans GB W3", "WenQuanYi Micro Hei", sans-serif;
        }

        h1,
        .h1,
        h2,
        .h2,
        h4,
        .h4,
        h4,
        .h4,
        .lead {
            font-family: "Microsoft YaHei UI", "Microsoft YaHei", "ff-tisa-web-pro-1", "ff-tisa-web-pro-2", "Lucida Grande", "Helvetica Neue", Helvetica, Arial, "Hiragino Sans GB", "Hiragino Sans GB W3", "WenQuanYi Micro Hei", sans-serif;
        }

        .dw-day {
            font-size: 12px;
        }

        .sub-row {
            height: 30px;
        }

        .serologic-result-div {
            display: flex;
            justify-content: space-around;
            align-items: center;
            height: 50px;
        }

        .serologic-result-item {
            display: flex;
        }

        .serologic-result-item img {
            max-width: 100%;
            height: 17px;
        }

        .serologic-result-item span {
            font-size: 0.8em;
            padding-left: 5px;
        }

        .sel-info img {
            max-width: 100%;
            height: 22px;
            vertical-align: middle;
        }

        .serologic-img {
            width: 87px !important;
            height: 20px !important;
        }

        .sel-note {
            float: right;
            line-height: 46px;
            color: #c9c9c9;
            font-size: 16px;
        }
        .prompt_message_icon {
            float: left;
            padding-top: 11px;
            padding-left: 16px;
            width: 24px;
            height: 24px;
        }
        .prompt_message_s {
            float: left;
            color: #ffffff;
            font-size: 18px;
            padding-left: 0px;
            padding-top: 11px;
            margin: 0;
        }
        .coupon_sel_0{
            background:#e5e5e5;
        }
        .coupon_sel_1{
            background:#ffb9af;
        }
        .coupon_sel_tip{
            font-size:10px;
        }
        .coupon_sel_info{
            width:245px;
            height:60px;
            float:left;
            overflow: auto;
            margin:5px 0 0 0;
            background:rgba(255, 255, 255, 0);
        }
        .coupon_sel_tip{
            font-size:12px;
            height:20px;
            line-height:15px;
        }
        .coupon_sel_name{
            height:30px;
            line-height:24px;
        }
        .coupon_sel_icon{
            display:none;
            height:24px;
            width:24px;
        }
        .coupon_sel_iconbox{
            margin:0 5px 0 0;
            padding:10px 0 0 0;
            float:right;
            width:50px;
            height:60px;
        }
        .coupon_sel_status_0{
            text-align:center;
            font-size: 14px;
            padding:4px 0 0 0;
            height:30px;
            width:50px;
            
        }
        .coupon_sel_status_1{
            font-size: 14px;
            text-align:center;
            padding:4px 0 0 0;
            height:30px;
            width:50px;
        }
    </style>
    <style>
            /*分页按钮开始*/
            .pagination {
                display: inline-block;
                /*border: 1px solid #CDCDCD;*/
                /*border-radius: 3px;*/
            }
            .pagination a {
                display: block;
                float: left;
                width: 20px;
                height: 20px;
                outline: none;
                border-right: 1px solid #CDCDCD;
                border-left: 1px solid #CDCDCD;
                color: #555555;
                vertical-align: middle;
                text-align: center;
                text-decoration: none;
                font-weight: bold;
                font-size: 16px;
                font-family: Times, 'Times New Roman', Georgia, Palatino; /* ATTN: need a better font stack */
                    
            }
            .pagination a:first-child {
                border: none;
                border-radius: 2px 0 0 2px;
            }
    
            .pagination a:last-child {
                border: none;
                border-radius: 0 2px 2px 0;
            }
    
            .pagination input {
                float: left;
                margin: 0;
                padding: 0;
                width: 120px;
                height: 20px;
                outline: none;
                border: none;
                vertical-align: middle;
                text-align: center;
            }
    
            /* gigantic class for demo purposes */
    
            .gigantic.pagination {
                margin: 10px 0;
            }
    
            .gigantic.pagination a {
                height: 40px;
                width: 40px;
                font-size: 30px;
                line-height: 30px;
            }
    
            .gigantic.pagination input {
                width: 120px;
                height: 30px;
                font-size: 14px;
            }
            /*分页按钮结束*/
            .remark {
                font-size: 12px;
                color: #07b8dd;
            }
    
            .sub-sheet {
                font-size: 12px;
            }
            /*搜索框*/

            div.search {
                padding: 10px 0;
            }

            .searchD1 {
                position: relative;
                width: 200px;
                margin: 5px 0 0 10px;
            }

            div.search {
                background: #dfdfdf;
            }

            div.search input {
                width: 100%;
                height: 30px;
                padding-left: 10px;
                border: 2px solid #7BA7AB;
                border-radius: 5px;
                outline: none;
                background: #F9F0DA;
                color: #9E9C9C;
            }

            div.search button {
                position: absolute;
                top: 0;
                right: -18px;
                width: 50px;
                height: 100%;
                border: none;
                background: #7BA7AB;
                border-radius: 0 5px 5px 0;
                cursor: pointer;
            }
            .sheet-row-baby{position: absolute;
                z-index: 1;
                right: 0px;
                margin-top: -20px;
            }
            .sheet-row-baby select{
                line-height: 30px;
                height: auto;
                text-align: right;
            }
            #nicu,#sickRoom,#pregnancyInfectionType{
                float: right;
                height: 47px;
                width: 150px;
                appearance: none;
                appearance: none;
                -moz-appearance: none;
                -webkit-appearance: none;
                border: none;
                outline: none;
                font-size: 16px;
                /*direction: rtl;*/
            }
            .clearFloat:after{height:0;clear:both;content:'';display:inline;visibility: hidden;}
            .clearFloat{*zoom:1;}
            #search{display:inline-block;*display:inline;*zoom:1; float:right;}
            div.selectList{display:inline-block;*display:inline;*zoom:1;float:right;}
            #province ,#city {height: 50px;font-size:15px; appearance: none; -moz-appearance: none;-webkit-appearance: none;border: none; outline: none; }
            #zhezhao{
                position: fixed;
                position: fixed;
                left:0;
                top:0;
                bottom:0;
                right:0;
                background:#000;
                opacity:0.5;
                display: none;
            }
            #dialogBox{
                width: 80%;
                height: 200px;
                border: 1px solid #dfdfdf;
                border-radius: 5px;
                position:fixed;
                left:50%;
                top:50%;
                transform:translate(-50%,-50%);
                background: #fff;
                display: none;
            }
            .dialogBoxTitle{
                height: 50px;
                line-height: 50px;
                text-align: center;
                border-bottom: 1px solid #dfdfdf;
                box-sizing: border-box;
                font-size: 18px;
            }
            .dialogBoxContent{
                height: 150px;
                display: flex;
                align-items: center;
                justify-content: center;
                margin: 0 20px;
                text-align: center;
            }
            .dialogBoxButten{
                height: 50px;
                display: flex;
                align-items: center;
                justify-content: center;
            }
            .dialogBoxButten span{
                display: inline-block;
                width: 90px;
                height: 35px;
                line-height: 35px;
                color: #fff;
                border-radius: 5px;
                cursor: pointer;
                text-align: center;
            }
            .dialogBoxButten .dialogCommit{
                background: #337ab7;
            }
        </style>
    <script type="text/javascript">
        var orderData = '';
        var area2 = new LArea();
        // var BASEURL = 'http://192.168.31.250';
        var BASEURL = '';
        $(document).ready(function () {
                var curr = new Date().getFullYear();
                var currMonth = new Date().getMonth() + 1;
                var opt = {};
                opt.date = { preset: 'datetime' };
                opt.datetime = { preset: 'datetime' };
                opt.default = {
                    theme: 'android-holo light', //皮肤样式
                    display: 'modal', //显示方式
                    mode: 'scroller', //日期选择模式
                    dateFormat: 'yy-mm-dd',
                    lang: 'zh',
                    showNow: false,
                    stepMinute: 5,
                    startYear: 1920, //开始年份
                    endYear: curr + 0 //结束年份
                };
                $('.settings').bind('click', function () {

                    var demo = 'datetime';
                    if (!demo.match(/select/i)) {
                        $('.demo-test-' + demo).val('');
                    }
                    $('.demo-test-' + demo).scroller('destroy').scroller($.extend(opt['date'], opt['default']));

                    $('.demo').hide();
                    $('.demo-' + demo).show();
                });
                $('#demo').trigger('click');
                $('.settings1').bind('click', function () {

                    var demo = 'datetime';
                    if (!demo.match(/select/i)) {
                        $('.demo-test-' + demo).val('');
                    }
                    $('.demo-test-' + demo).scroller('destroy').scroller($.extend(opt['date'], opt['default']));

                    $('.demo1').hide();
                    $('.demo-' + demo).show();
                });
                $('#demo1').trigger('click');
                if (orderData) {
                    var obj = JSON.parse(orderData);
                    $("#lastPeriod").val(obj.lastMenstrualPeriod);
                }
                //选择省市区信息
                resetSelect($('#province'), '', 10);
            });

        function areaInit() {
            area2.init({
                'trigger': '#area-opt',
                'valueTo': '#area-value',
                'keys': {
                    id: 'value',
                    name: 'text'
                },
                'type': 2,
                'data': [provs_data, citys_data, dists_data]
            });
        }
        //选择单位
        function selCustomer(obj){
            var id = obj.id;
            var value = $("#"+id).data("value");
            var input_value = $("#"+id).data("input");
            //alert(value);
            if(value.length > 15){
                value = value.substring(0,12) + '...';
            }
            $("#customer-value").text(value);
            $("#customer-value").css('color','#333');
            $("#customer").val(input_value);
            $("#customerName").val(value)
            //关闭浮层
            closeSelTips('customerSelDiv');
        }
        var queryCustomer={};
        //搜索客户
        function searchCustom() {
            var queryStr = $('#searchStr').val();
            doQuery();
        }
        var totalPage=0
        function doQuery() {
            $.ajax({
                type: "post",
                url: BASEURL+"/csfy/intf.do",
                data: {
                    method:'getCustomers',
                    addressCity:'长沙市',
                    productCode:'BS0002'
                },
                dataType: "json",
                success: function (data) {
                    var rows = data.rows;
                    var total = data.total;
                    var info = '0/0';
                    if (total && total != 0) {
                        totalPage = Math.ceil(parseInt(total) / queryCustomer.rows);
                        info = queryCustomer.page + ' / ' + totalPage;
                    }
                    $('#pageInfo').attr('value', info)
                    if (queryCustomer.page < totalPage) {
                        queryCustomer.page = queryCustomer.page + 1;
                    }
                    var cusStr = '';
                    if (rows) {
                        for (var key in rows) {
                            var obj = rows[key];
                            var str = '<li id="customer-' + key + '" data-input="' + obj['customerCode'] + '" data-value="' + obj['customerName'] + '" class="sel-info" onclick="selCustomer(this);">' + obj['customerName'] + '</li><div class="input-line"></div>';
                            cusStr += str;
                        }
                        $('#customerBox').html(cusStr);
                    } else {
                        var str = '<li style="text-align:center;color: #00afee;" id="customer-' + 0 + '" data-input="' + '' + '" data-value="' + '' + '" class="sel-info" onclick="selCustomer(this);">' + '没有数据' + '</li><div class="input-line"></div>';
                        $('#customerBox').html(str);
                    }
                }
            });
        }

        //省市区
        function resetSelect(jq, parentId, defaultIdx) {
            var url = BASEURL+'/csfy/intf.do?method=getAddrs';
            if (parentId) {
                url = url + '&parentId=' + parentId;
            }
            var jqId = '#' + jq.attr('id');
            $.getJSON(url, function (data) {
                if (data.msg === 'success') {
                    jq.empty();
                    $.each(data.rows, function (i, item) {
                        var option = $('<option></option>');
                        option.attr('value', item['code']);
                        option.text(item['name']);
                        jq.append(option);
                    });
                    if (defaultIdx) {
                        jq.get(0).selectedIndex = defaultIdx;
                        //alert(defaultIdx);
                    }

                    if (jqId) {
                        addressChange(jqId);
                    }
                    //jq.selectpicker('refresh');

                    //将选择的值放入隐藏文本框中，方便验证
                    var province=$("#province option:selected").text();
                    var city=$("#city option:selected").text();
                    //alert(province + "省" + city);
                    if(province != "" && city !=""){
                        $("#nativePlace1").val(province);
                        $("#nativePlace2").val(city);
                    }
                }
            });
        }
        function addressChange(id) {
            var code = $(id).children('option:selected').attr('value')
            switch (id) {
                case '#province':
                {
                    var defaultIdx = undefined;
                    if (code == 43) {
                        defaultIdx = 8;
                    }
                    resetSelect($('#city'), code, defaultIdx);

                    break;
                }
                case '#city':
                {
                    resetSelect($('#county'), code);
                    $('#town').empty();
                    //$('#town').selectpicker('refresh');
                    break;
                }

            }
        }
        //选择性别
        function selGender(obj){
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#gender-value").text(value);
            $("#gender-value").css('color','#333');
            $("#sampleSex").val(input_value);
            $("#sampleName-value").text("请选择");
            $("#name").val("");
            $(".babyName").show();
            if(input_value == 1){
                $("#sampleName-0").text($("#motherName").val() + "大子").data("value",$("#motherName").val() + "大子");
                $("#sampleName-1").text($("#motherName").val() + "二子").data("value",$("#motherName").val() + "二子");
                $("#sampleName-2").text($("#motherName").val() + "三子").data("value",$("#motherName").val() + "三子");
            }else if(input_value == 2){
                $("#sampleName-0").text($("#motherName").val() + "大女").data("value",$("#motherName").val() + "大女");
                $("#sampleName-1").text($("#motherName").val() + "二女").data("value",$("#motherName").val() + "二女");
                $("#sampleName-2").text($("#motherName").val() + "三女").data("value",$("#motherName").val() + "三女");
            }
            //关闭浮层
            closeSelTips('genderSelDiv');

        }
        function motherNamechange() {
            $("#sampleName-value").text("请选择");
            $("#name").val("");
            if($("#sampleSex").val() == 1){
                $("#sampleName-0").text($("#motherName").val() + "大子").data("value",$("#motherName").val() + "大子");
                $("#sampleName-1").text($("#motherName").val() + "二子").data("value",$("#motherName").val() + "二子");
                $("#sampleName-2").text($("#motherName").val() + "三子").data("value",$("#motherName").val() + "三子");
            }else if($("#sampleSex").val() == 2){
                $("#sampleName-0").text($("#motherName").val() + "大女").data("value",$("#motherName").val() + "大女");
                $("#sampleName-1").text($("#motherName").val() + "二女").data("value",$("#motherName").val() + "二女");
                $("#sampleName-2").text($("#motherName").val() + "三女").data("value",$("#motherName").val() + "三女");
            }
        }
        //选择新生儿姓名
        function setsampleName(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            // alert(value + input_value);
            $("#sampleName-value").text(value);
            $("#sampleName-value").css('color','#333');
            $("#name").val(value);
            //关闭浮层
            closeSelTips('sampleNameDiv');
        }
//选择样本类型
function selSampleType(obj){
    var id = obj.id;
    var value = $("#"+id).data("value") ;
    var input_value = $("#"+id).data("input");
    //alert(value);
    $("#sampleType-value").text(value);
    $("#sampleType-value").css('color','#333');
    $("#sampleType").val(input_value);
    //关闭浮层
    closeSelTips('sampleTypeSelDiv');

}
//产后72小时
function suckler72(obj){
	var id = obj.id;
    var value = $("#"+id).data("value") ;
    var input_value = $("#"+id).data("input");
    //alert(value);
    $("#suckler72_value").text(value);
    $("#suckler72_value").css('color','#333');
    $("#suckler72").val(input_value);
    console.log($("#suckler72").val());
    //关闭浮层
    closeSelTips('sucklerDiv');
}
//分娩方式
function delivery(obj){
	var id = obj.id;
    var value = $("#"+id).data("value") ;
    var input_value = $("#"+id).data("input");
    //alert(value);
    $("#deliveryMode_value").text(value);
    $("#deliveryMode_value").css('color','#333');
    $("#deliveryMode").val(input_value);
    console.log($("#deliveryMode").val());
    //关闭浮层
    closeSelTips('deliveryDiv');
}
//弹出提示框
function openPrompt(promptInfo){
	$("#fade").css("display","block");
	$("#tipDia").css("display","block");
    $("#tipmsg").text(promptInfo);
}
//提交表单数据
function commitForm(){
	var postData = {
		productCode:"BS0002",
		productName:"新生儿疾病筛查"
	};
	//医生必录
	if ($("#doctorName").val().length > 0) {
		postData.doctorName = $("#doctorName").val();
	}else{
		openPrompt("请输入医生姓名");
		return false;
	}
	//样本类型必录
	if ($("#sampleType").val().length == 0) {
		openPrompt("请选择样本类型");
		return false;
	}else{
		postData.sampleType = $("#sampleType").val();
	}
	//采样日期必录
	if ($("#bloodDate").val().length == 0) {
		openPrompt("请选择采样日期");
		return false;
	}else{
		postData.bloodDate = $("#bloodDate").val();
	}
	//受检人姓名必录
	if ($("#sampleName").val().length == 0) {
		openPrompt("请输入受检人姓名");
		return false;
	}else{
		postData.sampleName = $("#sampleName").val();
	}
	//受检人性别非必录
	if ($("#sampleSex").val().length > 0) {
		postData.sampleSex = $("#sampleSex").val();
	}
	//受检人出生日期非必录
	if ($("#birthday").val().length > 0) { 
		postData.birthDate = $("#birthday").val();
	}
	//受检人类型非必录
	if ($("#personType").val().length > 0) {
		postData.personType = $("#personType").val();
	}
	//受检人籍贯非必录
	if ($("#nativePlace").val().length > 0) {
		postData.nativePlace = $("#nativePlace").val();
	}
	//受检人民族非必录
	if ($("#nationaltily").val().length > 0) {
		postData.nationaltily = $("#nationaltily").val();
	}
	//监护人姓名必录
	if ($("#guardianShip").val().length > 0) {
		postData.guardianShip = $("#guardianShip").val();
	}else{
		openPrompt("请输入监护人姓名");
		return false;
	}
	//监护人联系电话必录
	if ($("#phone").val().length == 0) {
		openPrompt("请输入监护人联系电话");
		return false;
	}else{
		postData.motherPhoneNum = $("#phone").val();
	}
	//监护人电子邮箱地址非必录
	if ($("#sampleRecipientEmail").val().length > 0) {
		postData.sampleRecipientEmail = $("#sampleRecipientEmail").val();
	}
	//身份证号码必录
	if ($("#idnumber").val().length == 0) {
		openPrompt("请输入身份证号码");
		return false;
	}else{
		postData.idCard = $("#idnumber").val();
	}
	//报告发送地址非必录
	if ($("#reportAddress").val().length > 0) {
		postData.reportAddress = $("#reportAddress").val();
	}
	//临床表现非必录
	if ($("#clinicalManifestation").val().length > 0) {
		postData.clinicalManifestation = $("#clinicalManifestation").val();
	}
	//产后24小时非必录
	if ($("#bear24Hour").val().length > 0) {
		postData.bear24Hour = $("#bear24Hour").val();
	}
	//出生时体重非必录
	if ($("#bodyWeight").val().length > 0) {
		postData.bodyWeight = $("#bodyWeight").val();
	}
	//出生时身高非必录
	if ($("#bodyHeight").val().length > 0) {
		postData.bodyHeight = $("#bodyHeight").val();
	}
	//apgar评分非必录
	if ($("#apgar").val().length > 0) {
		postData.apgar = $("#apgar").val();
	}
	//出生72小时非必录
	if ($("#suckler72").val().length > 0) {
		postData.suckler72 = $("#suckler72").val();
	}
	//分娩方式非必录
	if ($("#deliveryMode").val().length > 0) {
		postData.deliveryMode = $("#deliveryMode").val();
	}
	//母亲姓名非必录
	if ($("#motherName").val().length > 0) {
		postData.motherName = $("#motherName").val();
	}
	//母亲年龄非必录
	if ($("#motherAge").val().length > 0) {
		postData.motherAge = $("#motherAge").val();
	}
	//父亲姓名非必录
	if ($("#dnaFatherName").val().length > 0) {
		postData.dnaFatherName = $("#dnaFatherName").val();
	}
	//父亲年龄非必录
	if ($("#fatherAge").val().length > 0) {
		postData.fatherAge = $("#fatherAge").val();
	}
	//家族史非必录
	if ($("#familyProduce").val().length > 0) {
		postData.familyProduce = $("#familyProduce").val();
    }
    
    //设置模板文件，pc端送检单列表点击编辑才可以进入编辑界面
    postData.fileVer = "temp/akxChildGenTest.jsp";
   
    console.log(postData);
    
	$.ajax({
        type:"post",
        url:"/csfy/wx/createSampleBase.do",
        data:postData,
        dataType:"json",
        success:function (data) {
            openTips('提交成功');
            $('body').html('<div style="margin-top:100px;text-align:center;color:#00ff00;font-size:30px;">送检单提交成功</div>')
        }
    })
}
    </script>


</head>

<body onload="orderSheetOnLoad();">
    <!--送检单信息-->
    <form id="actform" name="actform" action="" method="post">
        <input class="submit" id="id" name="id" type="hidden" value="1000862" />
        <input id="needOtherReport" name="needOtherReport" type="hidden" value="1" />
        <!--顶部图标-->
        <div class="sheet-title">
            <!-- <img src="./images/order/nifty-top-banner.png" alt="title icon" /> -->
            <div style="padding:10px 0 10px 0;font-size:24px;color:#07b8dd;text-align:center;">新生儿疾病筛查</div>
            <div onclick="useCoupon()" style="margin:0 auto; overflow:hidden;">
                <img id="coupon_icon" class="prompt_message_icon" style="display:block;width:24px;height:24px;" src="./images/order/coupon.png">
                <div id="coupon_title" class="prompt_message_s" style="color: red;margin:0 0 10px 10px;cursor:pointer;">点击使用免费券</div>
            </div>
        </div>
        <!-- 送检单信息 -->
        <div class="sheet-box">

            <div class="input-line"></div>
            <div class="sheet-row">
                <span style="color: #c00">*</span><span class="input-title">收费类型</span>
                <input class="submit" id="isChargeA" type="text" value="自费" disabled="disabled" />
                <input class="submit" id="isCharge" name="isCharge" type="hidden" value="2" />
            </div>
        </div>
        <!--受检者信息-->
        <div class="sheet-box">

            <div class="sheet-row">
                <span style="color: #c00">*</span><span class="input-title">母亲姓名</span>
                <input class="submit" id="motherName" name="motherName" type="text" placeholder="请输入母亲姓名" value="" onchange="motherNamechange()" />
            </div>
            <div class="input-line"></div>
            <div class="sheet-row">
                <span style="color: #c00">*</span><span class="input-title">母亲年龄</span>
                <input class="submit" id="motherAge" name="motherAge" type="number" placeholder="请输入母亲年龄" value="" />
            </div>
            <input class="submit" id="sampleSex" name="sampleSex" type="hidden" value="">
            <div class="sheet-row" onclick="openSelectTip('genderSelDiv')"><span class="input-title"><span style="color: #c00">*</span><span style="color: #c00"></span>新生儿性别</span>
                <div class="select-right" id="genderSel">
                    <p><span id="gender-value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
            <div class="input-line"></div>
            <input class="submit" id="name" name="sampleName" type="hidden" value="" />
            <div class="sheet-row babyName" onclick="openSelectTip('sampleNameDiv')" style="display: none;">
                <span class="input-title">
                    <span style="color: #c00">*</span>新生儿姓名</span>
                <div class="select-right" id="sampleName">
                    <p>
                        <span id="sampleName-value">请选择</span>
                        <span>
                            <img class="tips-icon" src="./images/order/select-icon.png" alt="select icon" />
                        </span>
                    </p>
                </div>
            </div>
            <div class="input-line"></div>
            <div class="sheet-row">
                <div class="date-pick">
                    <span style="color: #c00">*</span><span class="input-title"><span style="color: #c00"></span>出生日期</span><img id="birthday-tips" class="tips-icon" style="height:20px;padding-bottom: 6px; display: none;" src="./images/order/qs-tip-redonly.png" alt="tips icon"/>
                    <div class="settings" style="display:none;">
                        <select name="demo" id="demo">
                            <option value="date">日期</option>
                        </select>
                    </div>
                    <input name="birthDate" id="birthday"
                        class="submit demo-test-date demo-test-datetime demo-test-time demo-test-credit"
                        placeholder="请选择新生儿出生日期"
                        style="padding-top:4px" onchange="" value=""/>
                </div>
                <span style="float:right" onclick="triggerDate();"><img class="tips-icon date-pick-img" src="./images/order/select-icon.png" alt="select icon"/></span>
            </div>

            <div class="input-line"></div>
            <div class="sheet-row clearFloat">
                <span style="color: #c00">*</span><span class="input-title">籍贯</span>
                <div class="selectList">
                    <input type="hidden" id="nativePlace1" validate="required" style="width: 90px;">
                    <!-- <span class="input-title">省</span>-->
                    <div style="display:inline-block;">
                        <select id="province" onchange="addressChange('#province')" class="selectpicker form-control" data-live-search="true" data-max-options="1"  style="background: #fff;direction: rtl;">
                            <option value="">请选择</option>
                        </select>
                    </div>
                </div>
            </div>
            <div class="input-line"></div>
            <div class="sheet-row clearFloat">
                <div class="selectList">
                    <input type="hidden" id="nativePlace2" validate="required" style="width: 90px;">
                    <div style="display:inline-block;">
                        <select id="city" onchange="addressChange('#city')" class="selectpicker form-control" data-live-search="true" data-max-options="1"  style="background: #fff;direction: rtl;">
                            <option value="">请选择</option>
                        </select>
                    </div>
                </div>
            </div>
            <div class="input-line"></div>
            <div class="sheet-row">
                <span style="color: #c00">*</span><span class="input-title">民族</span>
                <input class="submit" id="nationaltily" name="nationaltily" type="text" placeholder="请输入新生儿的民族" value="" />
            </div>

                <div class="input-line"></div>
                <div class="sheet-row">
                    <span style="color: #c00">*</span><span class="input-title">母亲电话</span>
                    <input class="submit" id="phone" name="motherPhoneNum" type="tel" placeholder="请输入母亲联系电话" onchange="checkMobile('phone')"
                        value="" />
                </div>
                <div class="input-line"></div>
                <div class="sheet-row">
                    <span style="color: #c00">*</span><span class="input-title">其他联系电话</span>
                    <input class="submit" id="phone2" name="samplePhoneNum" type="tel" placeholder="请输入其他联系电话"
                           value="" />
                </div>

                <div class="input-line"></div>
                <div class="sheet-row">
                    <span style="color: #c00">*</span><span class="input-title">身份证</span>
                    <input class="submit" id="idnumber" name="idCard" type="text" placeholder="请输入领券时绑定的证件号码" onchange="checkIdNumber('idnumber')"
                        onkeyup="transX(this)" value="" />
                </div>

        </div>
        <!--临床信息开始-->
        <div class="sheet-box">
	        <div class="sheet-row">
                <span class="input-title">临床表现</span>
	            <input class="submit" id="clinicalManifestation" name="clinicalManifestation" type="text" placeholder="如有临床表现，请详细描述" value="" />
	        </div>

	        <div class="input-line"></div>
	        <div class="sheet-row">
                <span style="color: #c00">*</span><span class="input-title">出生时体重</span>
	            <span style="float: right;line-height: 50px;">g</span>
	            <input class="submit" id="bodyWeight" name="bodyWeight" type="number" placeholder="请输入" value="" />
	        </div>
	        <div class="input-line"></div>
	        <div class="sheet-row">
                <span class="input-title">出生时身高</span>
	            <span style="float: right;line-height: 50px;">cm</span>
	            <input class="submit" id="bodyHeight" name="bodyHeight" type="number" placeholder="请输入" value="" />
	        </div>
	        <div class="input-line"></div>
            <input class="submit" id="suckler72" name="suckler72" type="hidden" value="">
            <div class="sheet-row" onclick="openSelectTip('sucklerDiv')"><span style="color: #c00">*</span><span class="input-title"><span style="color: #c00"></span>是否充分哺乳(6~8次)</span>
                <div class="select-right" id="sucklerSel">
                    <p><span id="suckler72_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
            <div class="input-line"></div>
            <div class="sheet-row sheet-input sub-input">
                <span style="color: #c00">*</span><span class="input-title">分娩时孕周</span>
                <img id="yunzh-tips" class="tips-icon" style="height:20px;padding-bottom: 6px; display: none;" src="./images/order/qs-tip-redonly.png"
                     alt="tips icon" />
                <p id="yunzh" data-flag="0">
                    <input class="submit" id="gestationalWeeks" name="gestationalWeeks" type="hidden">
                    <input class="submit" id="gttWeek" name="gttWeek" type="number" onfocus="upbody('yunzh');" value="" />&nbsp;周&nbsp;&nbsp;
                    <input class="submit" id="gttDay" name="gttDay" type="number" onchange="checkGttDay('gttDay')" value="" />&nbsp;天
                </p>
            </div>
            <div class="input-line"></div>
            <input class="submit" id="deliveryMode" name="deliveryMode" type="hidden" value="" />
            <div class="sheet-row" onclick="openSelectTip('deliveryDiv')"><span class="input-title"><span style="color: #c00"></span>分娩方式</span>
                <div class="select-right" id="deliveryModeSel">
                    <p><span id="deliveryMode_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
	    </div>
        <!--临床信息结束-->
        <!--受检者亲属信息开始-->
        <div class="sheet-box">

	        <div class="input-line"></div>
	        <div class="sheet-row">
                <span class="input-title">家族史</span>
	            <input class="submit" id="familyProduce" name="familyProduce" type="text" placeholder="如果父母有家族遗传病史，请详细描述" value="" />
	        </div>

            <div class="sheet-row" style="display: flex;height: 80px;">
                <span class="input-title">备注</span>
                <textarea id="notes" style="flex: 1;height: 60px;margin-left: 20px;border: 1px solid #dfdfdf;"></textarea>
            </div>
        </div>
        <!--受检者亲属信息结束-->
    </form>

    <div id="ban_bt">
        <button id="bindbtn" onclick="checkForm();">提交</button>
    </div>
    <br/>

    <!-- 遮罩层 -->
    <div id="fade" class="black_overlay"></div>
    <!--================================================== -->
    <div id="sampleTypeSelDiv" class="select_content">
        <ul class="select-ul">
            <li class="sel-title">请选择样本类型</li>
            <li id="sampleType-0" data-input="05" data-value="干血片" class="sel-info" onclick="selSampleType(this);">
                干血片
            </li>
            <div class="input-line"></div>
            <li id="sampleType-1" data-input="01" data-value="全血" class="sel-info" onclick="selSampleType(this);">
                全血
            </li>
            <div class="input-line"></div>
            <li id="sampleType-2" data-input="08" data-value="口腔拭子" class="sel-info" onclick="selSampleType(this);">
                口腔拭子
            </li>
            <div class="input-line"></div>
            <li id="sampleType-3" data-input="18" data-value="唾液" class="sel-info" onclick="selSampleType(this);">
                唾液
            </li>
        </ul>
    </div>
    <div id="genderSelDiv" class="select_content">
        <ul class="select-ul">
            <li class="sel-title">请选择性别</li>
            <li id="gender-0" data-input="1" data-value="男" class="sel-info" onclick="selGender(this);">
                男
            </li>
            <div class="input-line"></div>
            <li id="gender-1" data-input="2" data-value="女" class="sel-info" onclick="selGender(this);">
                女
            </li>
        </ul>
    </div>
    <div id="sampleNameDiv" class="select_content">
        <ul class="select-ul">
            <li class="sel-title">本次分娩胎儿姓名</li>
            <li id="sampleName-0" data-input="1" data-value="" class="sel-info" onclick="setsampleName(this);">

            </li>
            <div class="input-line"></div>
            <li id="sampleName-1" data-input="2" data-value="" class="sel-info" onclick="setsampleName(this);">

            </li>
            <li id="sampleName-2" data-input="3" data-value="" class="sel-info" onclick="setsampleName(this);">

            </li>
        </ul>
    </div>
    <!--产后72小时-->
    <div id="sucklerDiv" class="select_content">
        <ul class="select-ul">
            <li class="sel-title">请选择</li>
            <li id="suckler-0" data-input="1" data-value="是" class="sel-info" onclick="suckler72(this);">
                是
            </li>
            <div class="input-line"></div>
            <li id="suckler-1" data-input="0" data-value="否" class="sel-info" onclick="suckler72(this);">
                否
            </li>
        </ul>
    </div>
    <!--分娩方式-->
    <div id="deliveryDiv" class="select_content">
        <ul class="select-ul">
            <li class="sel-title">请选择</li>
            <li id="delivery-0" data-input="0" data-value="平产" class="sel-info" onclick="delivery(this);">
                平产
            </li>
            <div class="input-line"></div>
            <li id="delivery-1" data-input="1" data-value="剖腹产" class="sel-info" onclick="delivery(this);">
                剖腹产
            </li>
        </ul>
    </div>
    <!-- 选择优惠券 -->
    <div id="couponSelDiv" class="select_content" style="height:100%;background: #ffffff">
        <div class="search">
            <div>
                <div style="height:40px;text-align:center;font-size:24px;padding:20px 0 0 0;margin:10px 0 10px 0;">已领取的免费券</div>
            </div>
            <a type="button" onclick="closeSelTips('couponSelDiv');" style="color:#07b8dd; position:absolute;right:10px;top:35px; height: 25px;">返回</a>
        </div>
        <div class="input-line" style="width: 100%;"></div>
        <div style="height: 80%; overflow:hidden; background: #ffffff">
            <ul id="couponBox" class="select-ul" style="overflow:auto; height: 100%; -webkit-overflow-scrolling : touch;">
                <li style="text-align:center;margin-left:auto;margin-right:auto;color: #00afee;" id="customer-0" data-input="" data-value="" class="sel-info" onclick="selCoupon(this);">
                    <span >您还没有免费券,您可以在公众号点击菜单我的服务-->领取免费券</span>
                </li>
            </ul>
        </div>
     </div>
     <div id="customerSelDiv" class="select_content" style="height:100%;background: #dfdfdf">
        <div class="search" style="width:100%;">
            <div class="searchD1">

            </div>
            <div style="text-align:center;font-size:30px;">请选择医院</div>
            <a type="button" onclick="closeSelTips('customerSelDiv');" style="color:#07b8dd; position:absolute;right:10px;top:25px; height: 25px;">取消</a>
        </div>
        <div class="input-line" style="width: 100%;"></div>
         <div style="height: 90%; overflow:hidden; background: #ffffff">
             <div style="height:50px;line-height:50px;display:flex;flex-direction:row;padding-left:15px">
                 <span>选择区县：</span>
                 <select value="" class="addressCounty" onchange="onAddressCountyChange(this.value,'DX0459')" style="margin-left: 10px; flex: 1; outline: none;font-size: 15px; color: #f00;"></select>
             </div>
             <div class="input-line"></div>
             <ul id="customerBox" class="select-ul" style="overflow:auto; height: 80%; -webkit-overflow-scrolling : touch;">
                 <li style="text-align:center;margin-left:auto;margin-right:auto;color: #00afee;" id="customer-0" data-input="" data-value=""
                     class="sel-info" onclick="selCustomer(this);">
                     <span>没有数据</span>
                 </li>

             </ul>
         </div>
    </div>
    <!-- 提示框 -->
    <div id="tipDia" class="tips">
        <p id="tipmsg" class="tips-msg"></p>
        <div class="tips-line"></div>
        <p class="tips-close" onclick="closeTips();">知道了</p>
    </div>

    <!--确认使用免费券-->
    <div id="zhezhao"></div>
    <div id="dialogBox">
        <div class="dialogBoxContent">您有未使用的新生儿疾病筛查免费券，点击确认使用</div>
        <div class="dialogBoxButten">
            <span class="dialogCommit">确认</span>
        </div>
    </div>
</body>

<script src="./js/order/newborn_sheet.js"></script>
</html>